ER Nurses-how do you orient your new grads?

[jessicaamjm]

Hi, I've been an ER nurse for four years and have been orienting new grads for three years.

We're a level II trauma center, 37 bed ER, 1:4 ratio.

New grads get up to six months of orientation. Can be released around four weeks sooner if ready.

I want to know how you teach them...from day one. For example: you start them shadowing you x3 days, then they take one patient a week and slowly build to taking all four. Or you have them do assessments only for one week and then manage meds only for a week, then manage the whole patient experience etc.

Or you have them do everything with you on every patient from day one and just explain everything along the way.

I want to make sure I have as many teaching options as possible, and I value the input you have. My ER is a tough one, we see as many patients as the level I trauma center in Houston. It's crazy. Please divulge!

[Cominginhot]

I really love new grads! I love that they come in as a blank slate, no bad habits!

My new grad residency is 12 weeks. I usually spend 2-3 weeks orienting them, having them follow me, practicing new skills (IV's, NG's, foley's, compressions during codes, medication administration, etc) learning to communicate with pt's (which can be harder than most think!), getting them acquainted with our charting system, and quizzing them on what they already know (what tests will we run on this 25yo F abd pain? what does this EKG rhythm look like to you? what side effects should we expect with this medications?)

After that, I have them take 1 pt and then progressing as I feel they are ready to. Towards the end, I give them 4 pt's and try my best not to help them out. Obviously, pt safety comes first and I would never allow them to cause harm, but I think it's important for my new grads to "drown" a little. They're going to have days where they spend the majority of their shift feeling like they're drowning, and I would MUCH rather them be familiar with that feeling while they still have a safety net, than to have them feel that when there is no one peering over their shoulder. Obviously, there are differing opinions on how new grads should be taught, but that is the way I feel works best. Also, I started as a new grad, so this also comes with the added bonus of what I preferred when I was learning.